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Articles


The Right Filler is Key to Successful Treatment
A Dermatologist Can Assess Your Skin and Select a Filler that Best Suits Your Particular Needs

press release from AAD

SAN FRANCISCO (March 3, 2006) * As people live longer and healthier lives, more and more of them are looking for ways to look as young as they feel. Because the aging process causes the face to lose underlying fat and collagen, the skin starts to sag and wrinkle. Wrinkle fillers, commonly known as fillers, can give the skin back its plumped up, youthful appearance, but the key to their successful use is knowing which of the many available options will work best for each individual.

Speaking today at the 64th Annual Meeting of the American Academy of Dermatology, dermatologist Derek D. Jones, M.D., assistant clinical professor of dermatology at the University of California, Los Angeles, said, "Fillers have become a popular means of addressing skin problems that result from aging, sun damage, trauma and/or scarring or disease. Because there are so many options, a dermatologist can recommend the filler that is best suited for the individual patient's needs."

Fillers are commonly used to treat facial lines and wrinkles, hollow cheeks, receding chins, thinning lips and wrinkles between the eyes. Other procedures such as laser rejuvenation, which can improve the skin's tone and texture, and botulinum rejuvenation, which can relax the muscles that cause wrinkling, can do many things to improve a person's appearance. However, they cannot address the loss of volume that happens with aging. Only fillers can increase the skin's volume, much like putty fills a crack.

Selecting the proper filler is an important part of the process. Some fillers are intended for superficial wrinkles and some work best for deeper wrinkles. Others are better for deep cheek hollows and facial lipoatrophy, the severe facial fat loss that can happen to people who are HIV-positive.

Dr. Jones participated in a study in which approximately 1,200 HIV-positive patients with lipoatrophy were treated with liquid injectable silicone, which permanently added volume to their faces. After five years, none of the patients has experienced any problems. The ongoing study will continue to assess the efficacy and safety of the procedure.

"Often, HIV-positive patients with lipoatrophy feel stigmatized and become depressed. The patients in the study were happy with their results, and many felt that the treatments helped to improve their quality of life," Dr. Jones said. "Liquid silicone is almost an ideal filler, but it is the least forgiving of all fillers. Since it is permanent, it must be used correctly and with good judgment. Although it works well for a variety of indications, it is best reserved for emotionally devastating conditions such acne scarring and HIV facial lipoatrophy where other fillers may not work as well."

There are many other types of fillers, including the following that are approved by the U.S. Food and Drug Administration (FDA) and are widely available:


  • Purified collagen from cattle and humans is most often used to treat very fine wrinkles around the eyes and mouth, deep lines and creases, depressed scars such as those from acne or chicken pox and to add volume to thin lips. Results last three to nine months.

  • Hyaluronic acid gel may be used to treat lines around the mouth and to plump lips. Results last three to six months.

  • Poly-L-lactic acid beads are commonly used to replace lost facial fat. Results last up to two years.

  • Self-donated fat, or fat transfer, is most often used to treat deep lines, deep scars, hollow cheeks and restore contour to a face. Results last one to three years.


Despite the ease of use and minimal risk, Dr. Jones stressed that fillers need to be injected by an experienced and well-trained physician, such as a dermatologist, in order to reduce the risk of side effects.

"Depending on the filler, side effects are usually temporary, lasting only two to three hours and may include temporary redness, swelling, tenderness and visible lumps. More serious side effects are rare but allergic reactions and soft tissue damage can happen," Dr. Jones said.

Another drawback to all fillers, except liquid injectable silicone, is that they are temporary, you may need multiple treatments to get the desired result, and you will need to maintain the results with additional treatments over time.

"When a dermatologist and a patient decide that using a filler is the appropriate treatment, the procedure can be done in the dermatologist's office and the patient can return to everyday activities immediately with no downtime," Dr. Jones said. "When the proper filler is selected and used by an experienced physician, most people will have successful results and will be very pleased."

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org


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